Risk factors for repeated recurrence of intracranial aneurysms treated with endovascular embolization

WANG Tao; ZHANG Hao; XING Yi Song

doi:10.13798/j.issn.1009-153X.2023.10.004

Abstract：Objective To investigate the risk factors for repeated recurrence of intracranial aneurysms treated with endovascular embolization.Methods The clinical data of 86 patients with intracranial aneurysms who underwent second endovascular embolization due to recurrence after first endovascular embolization from July 2018 to July 2022 were retrospectively analyzed.The reccurrence of aneurysms was diagnosed by DSA when the aneurysmal sac was significantly changed and clear than before or accompanied with bleeding.Multivariate logistic regression analysis was used to analysize the risk factors for recurrence after second endovascular embolization.Results According to the DSA,11 patients(12.79%)relapsed and 75 did not.Multivariate logistic regression analysis showed that the long-diameter of aneurysms≥10 mm,direct coil embolization and immediate Raymond grade≥Ⅱwere independent risk factors for recurrence of intracranial aneurysms after second embolization(P<0.05).A nomogram was constructed based on the above risk factors,whose C-index was 0.708(95%CI 0.667～0.808).ROC curve showed the area under the curve of the nomogram was 0.711(95%CI 0.686～0.813),the sensitivity was 68.40%,and the specificity was 83.00%.Conclusions Recurrence of intracranial aneurysms after embolization can occur again after re-embolization.The nomogram model based on the long-diameter of aneurysms,Raymond grade immediately after embolization and embolization method has good value in predicting recurrence.